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Having strange sensation in chest. Diagnosed as ectopic beats. Is this related to heart problem?

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Practicing since : 1966
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Hi Doctor,

I am a 24 year old male and since last early september I have been have strange sensations in my chest and worry its a heart related issue. In December I went to get testing done, bloods, holter monitor, 12 lead ekg, echo and then finally an event monitor for a week. The cardiologist diagnosed it as ectopic beats and said they can come and go and may pass completely after a few months. I know my anxiety levels are certainly up and I want to be able to relax more. After my results which came end of January or so I have felt much much better and the events became far more occasional. Until 9 days ago, I was working out in the gym and when I came up to shower I got a weird sensation in my chest as if I was gonna have a heart attack, it could have been an ectopic beat. That passed and returned 2 days later (saturday). By Sunday it had passed again and was fine mist of this week until about 5:15pm on thursday evening. For the first time since I have had this the feeling was now predominantly in the centre of my chest and is a tight or pressure kind of feeling and also almost directly parallel with it I have a pain in my back. It has come back and forth now for the last 36-40 hrs and is worrying me. I have also gotten the flutters that I had tended to get before and feel like i was gonna have a heart attack but each time has passed. Should I still be worrying that it could be my heart? Is it possibly something else, like a problem in my oesophagus or digestive tract (burping occasionally gives temporary relief). Or do you think it may be the ectopic beats accompanied with anxiety and am over exaggerating things in my head? This is deteriorating my life, I feel like if I exercise, drink alcohol, etc. I might not be able to take it, Im scared and would like some advice and opinion on the matter. The cardiologist I saw told me there was no need to hold back on anything.
Posted Thu, 11 Apr 2013 in Hypertension and Heart Disease
Answered by Dr. Anantharamakrishnan 10 hours later
Hi friend,
Welcome to Health Care Magic

Relax! You are too young to have heart attack!
ECHOcardiography has ruled out congenital heart disease; there is no basic disease of the valve, muscle and so on. / ensured normal function.
Blood tests have ruled out most biochemical problems...
You are tolerating the rate well - means that your heart is well compensated.

You stand an excellent chance of returning to normalcy.
Be positive – why fear the heart beats faster? The problem is only if it could not beat!
Be in touch with your doctor - it is a question of time and you will be well.
Medicine is well advanced nowadays – management is possible for almost all situations...

Anxiety / Alcohol / Tobacco (smoking) / Caffeine (too much coffee, cola) are common causes.
Medicines may be responsible – like Phenylephrine used for ‘cold’ / Salbutamol used for asthma

Specific treatment may not always be necessary. The first line medicine is generally beta blockers, like Metoprolol – slow release and small dose. It will benefit both anxiety and missed beats. Your doctor will give proper prescription and follow up. If they are not effective and if the problem is severe, several other classes of drugs are available – acting by different mechanisms - the specialist will decide tailored to your needs / they may have side effects and need follow up.

If the problem is bothering to the extent of interfering with life style, there is advanced technique of investigation – Electro Physiological Studies (EPS) > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. Though the test is the gold standard, it is INVASIVE and has a risk (though minimal) and is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. The treating doctor may suggest them depending on need, based on his assessment of the situation. This can be combined with radio frequency or cryo-ablation, eliminating the focus of abnormality...

Take care
Wishing speedy recovery
God bless
Good luck
Above answer was peer-reviewed by
Follow-up: Having strange sensation in chest. Diagnosed as ectopic beats. Is this related to heart problem? 42 hours later

thanks for getting back to me. What would you suggest to do then. Just try and relax and not over worry considering the diagnosis I was given and hopefully it will go away by itself or in time?

I occasionally get breathless walking or going up the stairs but then can be in the gym for 20 minutes and it feel normal. The pains in my chest could possibly be psychosomatic or muscular based?


Answered by Dr. Anantharamakrishnan 6 hours later

Heart pain is mostly brought on by effort ad relieved by rest. If you could work out in the gym for 20 minutes, then your symptoms are unlikely to be related to the heart. As you rightly point out, it should be Psychosomatic.
The way out will be to keep yourself busy! - concentrate on work; work more - you will have no time to worry! Develop good rapport with family and friends; get out and enjoy cinema, beach, park at weekends; have a hobby; practice yoga, relaxation exercises and so on....
All is well; all will be well.

All the best
Above answer was peer-reviewed by
Follow-up: Having strange sensation in chest. Diagnosed as ectopic beats. Is this related to heart problem? 2 days later
Thank you for your information.

I am going to try and be more positive and try and let the results put my mind at ease.

I ask one more question. When I exercise I become anxious and panic, my throat may get tight, muscles in my chest and back might get tight, feel a but light headed or dizzy. This happens I think becuase I worry I could have a heart attack if I exercise. Can you offer support or help on this?
Answered by Dr. Anantharamakrishnan 18 hours later
Heart attack is not common at this age
It is not common in people who exercise regularly
Your symptoms do not suggest attack

Fear of the problem is often worse than the problem itself.
The thing to worry is worry itself!

Enjoy life -
Have tests to exclude and reassure -
Psychological counselling can help.
Above answer was peer-reviewed by
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